Consent By completing this form and returning it to my school, I confirm that I am the parent or guardian of the student(s) listed above, and that I consent to allow for my student to be tested for COVID-19 during the 2021-2022 academic school year by providing a saliva sample. Once a week screening testing for COVID-19 is offered to students. I understand that COVID-19 testing for the student(s) is optional and that I may refuse to give consent, in which case, my student(s) will not be tested. I understand that my student(s) must stay home from school if feeling unwell. I understand that an independent laboratory acting on behalf of my school will conduct the weekly screening testing. I understand that in order for weekly screening testing to be performed at an independent laboratory, certain personal information regarding my student(s) will need to be communicated to the laboratory for purposes of administering the program, and only to the extent necessary to administer the program, including student name, date of birth, and school cohort. I understand that the school is not acting as my student’s healthcare provider, this testing does not replace treatment by my student‘s healthcare provider, and I assume complete and full responsibility to take appropriate action regarding the student’s test results. I understand that it remains my responsibility to seek medical advice, care and treatment for my student(s) from their healthcare provider. I understand that there is a possibility of false negative COVID-19 test results and that my student(s) could still be infected with COVID-19 even if the test result is negative. I also understand that if my student(s) tests positive for COVID-19, the test result will be reported to the local public health authority as required by law. Personal health information will not be released without written consent except when required by law.